Caesarean Section

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Caesarean section is so common that it has become a lifestyle statement. Although vaginal delivery is the natural method recommended by obstetricians, many tend to prefer a caesarean delivery to normal vaginal delivery.

Before planning the mode of delivery, you might want to know a bit of background, so you may make an informed decision.

Is Caesarean section essential?

According to statistics past caesarean section, breech presentation (baby’s bottom is down and the head is up) in a primi and foetal distress are the leading indications for caesarean section. Maternal indications are previous caesarean section, obstructive lesion (fibroid, ovarian tumour etc) in the pelvis and pelvic abnormalities that prevent engagement of the foetal head in the pelvic cavity. Engagement of foetal head means the descent of the foetal head through the pelvis so that its widest diameter passes through the upper edge of the pelvic cavity. Foetal indications are abnormal presentations, congenital foetal abnormalities, infections and situations where health of the baby may be improved by preventing trauma of a vaginal birth. Caesarean section benefits both the mother and the baby if the placenta is abnormal, foetal head is too large to go through the pelvis and if the mother is not capable of coping with the stress of a vaginal delivery (ex- severe heart diseases, respiratory diseases).

Caesarean delivery on maternal request is fraught with controversy. Although this is quite common in Sri Lanka, various colleges have set forth recommendations for caesarean section on maternal request. So do not go for a c-section because your neighbour did so; discuss with your doctor. Your case can be quite dissimilar.

What happens during Caesarea section?

Caesarea section starts with intra venous anaesthetic and antibiotic injections, spinal blocks so that you do not feel anything below the rib cage. Once you are anaesthetized and placed on the operating table a urinary catheter goes into the urinary bladder. This stays in for about 12 hours after surgery. Then the doctor cleans your tummy with betadine and surgical spirit and places sterile surgical drapes on you leaving only the surgical site exposed. A small screen prevents you seeing your abdomen. Actual section takes less than 10 minutes. You might feel like your tummy is being unzipped. Incision goes just above the pubic hair line. After the surgeon goes down to the uterus, he makes a small incision on the uterus till the water bag is exposed and then widens it bluntly. Amniotic fluid comes out when the water bag is broken and the surgeon then delivers the baby. Special manoeuvres are there for different foetal postures. Doctor then may show you your baby briefly and hand it over to the paediatrician. Stitching you back up takes a bit longer than it take to open. Once you are all stitched up, the surgical site dressing goes on and they shift you from the theatre to the recovery room.

What are the risks of caesarean section?

Now caesarean sections are extremely safe. Very rarely mother may react badly to anaesthetic drugs. Sometime adjacent structures may be damaged, especially in repeat sections where there are a lot of tissue adhesions. Sometimes you may bleed a lot due to poor uterine contractions. In susceptible individuals blood clots in legs and lungs can occur. Wound site infections are also common.

What should you do?

Discuss with your obstetrician and decide on the mode of delivery early. Do not hide anything, even trivial things from the doctor because some minor detail may shift later the decision completely. Get your medical problems sorted out, Follow the recommended exercise regimen and take medication regularly. 

 

By: Dr T. M. S. Sameera B. Madugalle MBBS (COL)  

Watch this video of a C Section being performed by Dr Vijith Vidyabhushana and his team members

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මෙම ලිපිය ඔබට ප්‍රයෝජනවත් වුනානම් හෝ ඔබේ මිතුරියකට ප්‍රයෝජනවත් වේ යයි සිතනවානම්, කරුණාකර පහත ඇති "recommend" ක්ලික් කිරීමෙන් එය බෙදා හදා ගැනීමට අමතක කරන්න එපා.

තවද, මෙම ලිපිය පිළිබඳව ඔබේ අදහස්, යෝජනා සහ අනෙකුත් මවුවරුන්/කාන්තාවන් හට ප්‍රයෝජනවත් වන ඔබේ අත්දැකීම් පහත ලියා තැබීමටද අප ආරාධනා කරමු.

ස්තුතියි!

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මෙම ලිපිය ඔබ වෙත ගෙන එන්නේ ලංකා හොස්පිටල්ස් ආයතනය වෙතිනි. This video was brought to you by Lanka Hospitals PLC.

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